Abstract P141: Severity and Outcome of Post-Cardiac Arrest Syndrome: A Tale of Two Cities
Introduction: The ultimate outcome of cardiac arrest survivors varies between hospital systems. Whether the outcome depends primarily upon pre- and intra-arrest conditions or upon the quality of post-arrest care remains unknown but needs to be explored given proposals to grade hospitals based upon survival outcomes in post-arrest patients. We hypothesize that the severity of the post-arrest syndrome on initial presentation to the hospital reflects pre- and intra- arrest conditions. To test this hypothesis, we compared the characteristics of the post-arrest syndrome in two different cities in the United States in which pre- and intra-arrest characteristics vary significantly.
Methods: We performed a two-center retrospective data analysis of patients who obtained ROSC from out-of-hospital cardiac arrest. Inclusion criteria consisted of out-of-hospital arrest, age >18 years, and successful ROSC. Exclusion criteria consisted of traumatic arrest. We used Chi-Square for comparisons between dichotomous variables, and Student T-test or Wilcoxon as appropriate for parametric and non-parametric continuous variables. Parametric continuous data is expressed by mean and standard deviation and non-parametric continuous data is expressed with medians and inter-quartile range.
Results: A total of 148 patients were analyzed, 71 from Detroit and 77 from Boston. Attached table⇓ shows comparisons.
Conclusions: The initial severity of the post-arrest syndrome reflects pre- and intra-arrest conditions and varies significantly depending on the location in which the cardiac arrest occurred. When comparing hospital systems for quality of post-arrest care, inherent differences in the presenting syndrome needs to be taken into account. Moreover, the differences in severity of post-arrest syndrome illustrated in this comparison may have implications for stratification of patients for potential post-arrest interventions.
This research has received full or partial funding support from the American Heart Association, Founders Affiliate (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont).